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Author ORCID Identifier


Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Lisa Chasan-Taber

Second Advisor

Penelope Pekow,

Third Advisor

John Sirard

Fourth Advisor

Nicole VanKim

Subject Categories

Maternal and Child Health


Physical inactivity and sedentary behavior during pregnancy are significant public health concerns as it can increase the risk of excessive gestational weight gain, gestational diabetes mellitus, pre-eclampsia, and preterm birth. Consequently, the American College of Obstetricians and Gynecologists and the 2018 Physical Activity Guidelines Advisory Committee Scientific Report have highlighted the importance of defining specific physical activity (PA) measures. The Physical Activity Questionnaire (PPAQ) continues to be the most widely used self-reported assessment tool during pregnancy as it was validated for use during pregnancy and includes measures of PA intensity, domain, and sedentary behavior. However, it has almost been two decades vii since the development of the original PPAQ. Since then, there have been significant changes to human behavior and advances in PA measurement tools. For each dissertation chapter, I used data from the PPAQ Validation Study (2019-2022, R21HD094565-01A1), a prospective cohort study of 50 eligible pregnant women enrolled in early pregnancy. Chapter 1 developed the updated PPAQ, and then determined its validity and reliability using an accelerometer and wearable camera in a free-living setting. The PPAQ is a reliable instrument and a valid measure of a broad range of PA during pregnancy. Chapter 2 determined the impact of the COVID-19 pandemic on PA and sedentary behavior during pregnancy using the PPAQ and the accelerometer using a cross-sectional and prospective study design. During pregnancy, significant increases in sedentary behavior and household/caregiving and decreases in transportation PA were observed after the pandemic. Chapter 3 developed and evaluated the internal and external validity of the PPAQ-Short Form (PPAQ-SF). The internal validity of the PPAQ-SF was evaluated using the updated PPAQ and accelerometer within the PPAQ Study. The external validity of the PPAQ-SF was evaluated in an independent sample (Proyecto Mama, N=222) using the updated and original PPAQ. The PPAQ-SF produced sufficient estimates of moderate-to-vigorous-physical activity (MVPA) compared to the updated and original PPAQ. In conclusion, the Updated PPAQ can be used as a valid and reliable measure of pregnancy PA and the PPAQ-SF can be an efficient tool to estimate MVPA.


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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Available for download on Saturday, February 01, 2025